Sedentary Behavior as a Mediating Mechanism: A PRISMA-Guided Meta-Analysis of School-Based Physical Activity and Adolescent Adiposity

DOI

10.2991/978-94-6239-807-8_22How to use a DOI?

Keywords

School-based intervention; Sedentary behavior; Body composition; Adolescents; Meta-analysis

Abstract

Background

/Objectives: Rising sedentary behavior and declining physical activity among adolescents have intensified the global burden of obesity and metabolic risk. Schools offer a uniquely scalable environment for intervention, yet evidence remains fragmented regarding how structured physical activity programs influence sedentary behavior and body composition. This study aims to synthesize evidence and clarify the mechanistic pathways linking school-based interventions, sedentary time reduction, and adiposity outcomes. Methods: A PRISMA-guided systematic review and meta-analysis were conducted using PubMed, Scopus, and Web of Science. Twenty-five studies (2010–2025) involving adolescents (aged 10–19 years) were included. Interventions comprised enhanced physical education, high-intensity interval training (HIIT), extracurricular activity, and multi-component programs. Outcomes included moderate-to-vigorous physical activity (MVPA), sedentary time, and body composition indicators (BMI, body fat percentage). Random-effects models and qualitative synthesis were applied. Results: School-based interventions consistently increased MVPA and reduced sedentary time (up to ≈ 203 minutes/day in some programs). Multi-component and higher-intensity interventions demonstrated stronger effects compared to single-component approaches. Improvements in body composition were observed, including reductions in BMI (MD = − 0.46 units) and body fat percentage, although effects varied by intervention duration and design. Notably, sedentary time reduction emerged as a key mediating pathway linking physical activity interventions to adiposity outcomes. Conclusion/Implications: This study advances an integrative perspective positioning sedentary behavior reduction as a central mechanism in optimizing adolescent health. Practically, it underscores the importance of structured, multi-component, and school-embedded interventions. The findings inform evidence-based policy and support the development of sustainable, context-sensitive health promotion strategies in educational settings.

Copyright

© 2026 The Author(s)

Open Access

Open Access This chapter is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

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TY  - CONF
AU  - Nofianti Indah Safitri
AU  - Moch. Yunus
AU  - Agung Kurniawan
AU  - Ilham Akbar Hardiansyah
AU  - Melina Putri Anggraeni
PY  - 2026
DA  - 2026/10/24
TI  - Sedentary Behavior as a Mediating Mechanism: A PRISMA-Guided Meta-Analysis of School-Based Physical Activity and Adolescent Adiposity
BT  - Proceedings of the Malang International Conference on Medical and Health Sciences (MICROMEDHS 2026)
PB  - Atlantis Press
SP  - 277
EP  - 290
SN  - 2468-5739
UR  - https://doi.org/10.2991/978-94-6239-807-8_22
DO  - 10.2991/978-94-6239-807-8_22
ID  - Safitri2026
ER  -